Tuberculosis 2

Question 1

5 symptoms of pulmonary TB infection

Answer 1

chronic cough >3 weeks (subacute). fever. night sweats. hemoptysis aka blood in sputum. weight loss.

Question 2

extrapulmonary TB: where in body? symptoms? what is catastrophic?

Answer 2

TB can occur in almost any part of the body. fever, night sweats and weight loss + symptoms related to site of infection. CNS

Question 3

diagnosing TB: three steps?

Answer 3

clinical assessment. markers of active TB. markers of latent TB.

Question 4

diagnosing TB: clinical assessment (3)

Answer 4

epidemiological risk. symptoms/signs of TB. risk assessment for progression to active disease.

Question 5

diagnosing TB: markers of active TB (3)

Answer 5

diagnostic imaging. microbiologic work up. biopsy.

Question 6

diagnosing TB: markers of latent TB (2)

Answer 6

TST aka tuberculin skin test. interferon gamma release assays IGRA

Question 7

what’s really strongly related to TB

Answer 7

HIV/AIDS

Question 8

chest radiography: who do you do it in?

Answer 8

signs/symptoms of active TB disease. history of prior TB disease. high risk for development of active TB (like immunocompromised or HIV infected)

Question 9

sampling for AFB: how many samples?

Answer 9

3 samples for best balance between sensitivity and efficiency

Question 10

TST: diagnosis? what does it identify?

Answer 10

can’t diagnose active TB disease. identifies exposure/latent infection.

Question 11

TST: healthy individuals develop ____ in what time frame? then will show what?

Answer 11

cell mediated reactivity to tuberculin antigen 3 - 8 weeks after being infected with TB. will see induration 48 - 72 hours after test.

Question 12

interpretation of TST takes what factors into account?

Answer 12

size of induration. positive predictive value (consider possibility of false positive results secondary to non tubercuous mycobacteria or BCG vaccination). risk of progression to active infection

Question 13

interferon gamma release assays: measure what?

Answer 13

amount of INF-g produced in response to stimulation by mycobacterial peptides

Question 14

interferon gamma release assays can’t distinguish from? but can do what?

Answer 14

between latent and active disease. but is unaffected by prior BCG vaccination

Question 15

treating TB: 4 steps

Answer 15

interrupt transmission. relieve symptoms. prevent drug resistance. provide cure + prevent relapse

Question 16

first line TB drugs

Answer 16

RIPE = rifampin, isoniazid, pyrazinamide, ethambutol.

Question 17

second line TB drugs

Answer 17

fluoroquinolones . injectables like amikacin